Spirit of Christmas - Part 2
by Melissa Rivers
Summary: It's Christmas in the ER and a few surprises abound


SPIRIT OF CHRISTMAS  
by Missy  
(missy@lexicon.net)  
  
PART 2/?  
  
In Trauma Two, Kerry was trying to stabilise the five year old girl  
assisted by Dr. Anna Del Amico and several ER nurses.  
  
"CBC, Chem 7, Blood gas, coag panel, H&H, type and cross for eight."   
Kerry instructed as she began her exam. "Atropine, 5 mics per kilo and  
two of saline on the rapid infuser."  
  
"ET tray, size 5.0 ET tube" Anna called. Deftly she inserted the tube  
down the child's trachea and Lydia was ready to attach the ambu-bag to  
the tube with Chuny taping the ET tube in place. Anna quickly moved to  
check the chest for the correct placement of the tube. "Chest x-ray."  
  
"Two units of O neg. stat. Good breath sounds bilaterally." Kerry  
commented having also checked the child's lungs.   
  
"Dip the urine for blood, Guiac and prep for a lavage" called Anna.  
  
"BP's 70 palp, pulse ox is 80" Chuny announced. She began attaching  
cardiac monitors to keep a much closer eye on the child's stability.  
  
Shining her penlight into the child's eyes, Kerry noted the change.   
"Blown right pupil". All the staff now became aware of the probability  
of an intercranial hemorrhage. "Mannitol 5 mgs Stan. head CT, cross-  
table CT spine, pelvic and lower extremity x-rays."  
  
Dr. Peter Benton entered the Trauma room. "You called for a surgical  
consult."  
  
"We have a five year old victim suffering from head chest and lower  
limb injuries. GCS is 7, blown right pupil. Guiac and a dip is being  
done and we have prepped for a lavage." Kerry informed him.   
  
Benton palpitated the girls stomach. As he did so the results of the dip  
and guiac were obtained.   
"Guiac is clear, urine dip is positive." Anna confirmed.  
  
"Okay, DPL tray." Benton ordered. "Another two units of O neg."  
  
Anna swabbed the lower abdomen ready for Benton to perform the  
peritoneal lavage. Benton made a small incision just below the child's  
abdomen, inserting a small catheter into the abdominal cavity. He ran a  
small amount of saline solution into the abdomen, lavaging the cavity  
before removing the catheter for analyzing. Blood was in the fluid.  
  
"Okay, we've got a intra-abdominal bleed here." Benton stated. "Call  
the OR and let them know we're bring her up."  
  
All of a sudden, the monitors began screaming their warning. "I've lost  
the pulse." Chuny called out.  
  
Anna began compressions as Lydia continued with the ambu-bag.   
  
"Crash cart" called Kerry. "An amp of epi and one mig of atropine."  
  
The activity in the trauma room took a rapid increase in pace as the team  
worked as one, each anticipating and meeting the other's requirements.  
  
"Charge to 200" instructed Benton as he rubbed the defibrillator paddles  
together to smooth the gel over the entire surface. He placed the paddles  
on the child's chest. "Clear" he yelled and all the team cleared from  
contact with the gurney as he discharged the defibrillator. They all  
watched for a change in the monitor.   
  
Lydia and Anna recommenced CPR.  
  
"Charge again to 300" commanded Benton. He waited for the  
defibrillator to charge and then ordered everyone to clear before sending  
the electrical current through the girl's chest.  
  
The cardiac monitor began to register a faint heart beat. Kerry felt the  
carotid pulse which she found to be weak and slow.  
  
"Another mig of atropine." she ordered.  
  
The heart beat and pulse got stronger.  
  
"BP's 65 over 40" Anna reported. Lydia continued her regular  
compressions on the ambu-bag.  
  
"15 mics of dopamine IV infusion" instructed Benton checking the  
breath sounds and heart.  
  
"Asystole" called Anna as they once again lost the girl's pulse. "Neck  
veins are distended."  
  
"Can't hear any heart sounds. Pericardium tamponade" Benton  
instructed. "Pericardiocentesis tray."  
  
Kerry prepped the area with betadine whilst Peter grabbed the gauge 14  
needle from the tray Chuny had placed at his hands. Benton inserted  
the needle through the chest wall into the pericardial sac where fluid was  
rapidly filling, compressing the heart. As he pressed forward with the  
needle, he gently pulled back on the syringe. The fluid began filling the  
tube.   
  
"I've got a pulse." called Chuny.  
  
"BP's 85 over 60" confirmed Anna. Still not good but it looked like she  
had stabilised for now.   
  
- 0 0 0 -  
  
Having just finished suturing up a superficial knife wound on a teenage  
boy, Jeanie walked back to the admit desk. As she walked, she finished  
filling in the last of the details needed for all the paperwork to be in order  
and satisfy the hospitals administrators. A distraught couple were trying  
to speak with Randi, who was trying vainly to calm them down, while  
being interrupted by an abusive patient in the waiting area.  
  
"Can I help you?" Jeanie asked.  
  
Randi looked relieved as she now only had to manage the abusive  
patient. This was no problem to her as she could match the patient word  
for word, however, she knew if she wanted to keep her job, she would  
have to find another way of calming her.  
  
The couple immediately began pouring out a jumble of information  
about which Jeannie had no idea other than their children had been  
brought to the ER after an accident.  
  
"Mr. & Mrs........."   
  
"Richards" responded the husband.  
  
"Come and have a seat over here." Jeanie indicated at the seats in the  
admissions area. "I will just check at the desk about your children.   
What are their names and ages."  
  
"Aiden is six and Zoe is five." Mrs. Richards choked out. Having sat  
down, the couple huddled together, their arms around each other seeking  
security and comfort from the frightening events taking place. They had  
no idea of how seriously injured their children were other than they were  
hit by a car.  
  
Jeanie went up to Jerry who was on the phone.  
  
"Jerry, you speaking at the moment." she asked.  
  
"I'm on hold."  
  
"Have we had a six year old boy, Aiden Richards and five year old girl,  
Zoe Richards, admitted?"   
"Six year old and five year old were brought in fifteen minutes ago.   
H&R victims. Mark's in T 1 with the boy and Kerry's in T 2 with the  
girl. They weren't looking good when they came in. That the parents?"  
Jerry indicated with his head at the couple  
  
"Yeah. I'll get some details from them before I go and check out on  
how they are doing."   
  
"Yeah. We've had no details what....Yes." Jerry went back to his call as  
he was finally put through to radiology.  
  
Jeanie grabbed a couple of admission forms for the parents to complete.   
"Your children are here. They....."  
  
"Are they alright? What's happened to them? Can we see them?" The  
questions rolled over themselves as both parents looked at Jeanie,  
seeking some reassurance, their frightened eyes not wanting to imagine  
the fate of their children.  
  
"At the moment they are being treated. It would be best if you could  
both help us by filling out these forms. While you are filling them out, I  
will go and see how they are doing."  
  
Jeanie placed a clipboard in each of their hands with a pen. She left  
them as they struggled to overcome their fears and remember the correct  
answers to the often insignificant questions.   
  
"Mark. I've got the parents in admit."  
  
"Thanks Jeanie. I'll be there in a moment." Mark finished up giving  
instructions to the staff as the portable chest and radiologist arrived. As  
he moved through to Trauma Two, he removed his latex gloves and  
protective clothing.   
  
"The parents have arrived, what's the girls status?"  
  
"Intra-abdominal and intra-cranial bleed. We've just got her stabilised.   
Get them to sign consents." Kerry said sharply, her concentration fully  
on the patient before her.  
  
"Call the OR, we're bringing her up now!"   
  
Benton, Kerry and the nurses pushed the trolley out of the Trauma room  
to the lifts. Mark and Jeanie went to speak with the parents, Jeanie  
advising Mark of their names and those of the children as they went.  
  
"Mr. & Mrs. Richards. I'm Dr. Green. I've been treating your son."  
  
"What's wrong with him? Will he be okay?"  
  
"Take a seat." Mark motioned for them to sit down. He sat opposite  
them, perched on the edge of the seat as he began explaining the  
seriousness of their childrens' injuries.  
  
"Your children have both suffered major trauma. Your son had a  
collapsed lung when he arrived. We have managed to reinflate it and he  
is now breathing well. I'm waiting on lab results and x-rays before we  
will know any further details. At the moment, he is stable."  
  
Mr. & Mrs. Richards looked at each other, their hands held tightly  
together.  
  
"Your daughter has been taken for surgery. The injuries she sustained  
have caused haemorrhaging in her abdomen and brain. The surgeons are  
going to operate to stop the bleeding." Mark watched the parents, trying  
to gauge how much they were comprehending.  
  
"Haemorrhaging in her brain?" Mrs. Richards looked across at her  
husband and then back at Mark. "Does that mean she has brain  
damage?"  
  
"There is the possibility of brain damage however, we will not know  
until we run an EEG. Now, I have some consents for you to sign to  
authorise the surgercy." Mark handed over the consents and explained  
the procedure to ensure that they had full comprehension of the perilous  
situation their daughter was in.  
  
They both scrawled their signatures on the forms, hoping against all hope  
that they would be seeing their daughter and son again.  
  
"I will let you know when you can see your son." Mark left the couple,  
the wife in tears in her husband's arms as he fought to control his own.  
  
"Not good for the kids?" Jerry asked.  
  
"No."   
  
"Dr. Weaver. There's a visitor for you." Jerry said to Kerry as she  
returned from delivering the girl to the OR. He indicated to the far  
corner across from the central work station. She looked over and saw a  
young child curled up on the seat, playing a hand held computer game  
and froze for a moment. "Oh, here's a note the guy left for you. He  
seemed anxious to leave."  
  
"Thanks Jerry." She opened the note slowly, foreboding warning her that  
she was not going to like the contents. That her niece was sitting in the  
ER waiting room was warning enough. Quickly she scanned the note.   
"Damn you Brad, damn you to hell." she muttered forceably as she  
shoved the note into her pocket.   
  
Heads turned at the central work station, the deep-seated anger held in  
the softly spoken words gaining their attention. Pulling herself upright,  
Kerry took a deep breath to control the anger she was feeling and made  
her way across to the small child.   
  
Touching the little girl on the knee, Kerry smiled as the raven-haired girl  
looked up at her. "Hey Jess."  
  
Without a response, Jess jumped up on the seat and threw her arms  
firmly around Kerry's neck, almost overbalancing the two of them.   
Kerry returned her hug, relying on her crutch to help keep them balanced.  
  
Jess quickly signed to her.   
  
"I love you too." Kerry replied, her signing a bit rusty. "Come on, let's  
go talk."  
  
Jess jumped down from the seat and grabbed a backpack, shoving her  
computer game in before flicking it deftly over her shoulder. Reaching  
up, she put her small hand into Kerry's left hand and they went off to the  
lounge.   
  
Murmurs of curiosity floated around the desk. Mark cut them all short.   
"Jerry, what did that guy say when he left the note?"  
  
"He arrived when Dr. Weaver was treating the girl. He wanted to see her  
and was frustrated when I told him that she was treating a patient. At  
first he demanded that I get her. I told him it was a critical patient. He  
then demanded some paper and scrawled the message. With that, he put  
the child over there and left."  
  
"He just left?" Mark was astounded that a parent would just leave a child  
so young in a hospital.  
  
"Yeah. Real weird. Didn't seem worried about leaving a young child  
sitting here. Didn't even ask me to keep an eye on her. Oh, I did hear  
him saying something about 'Aunt Kerry' to the kid."   
  
Mark decided he had better go and speak to Kerry to find out exactly  
what was going on.   
  
"That was Weaver's brother?" Randi asked.  
  
'Must have been. They always say that every family has a black sheep."   
Jerry said flippantly as he passed a chart to Anna as she came to the desk.   
"Abdo pain in two."   
  
"Who Weaver or the brother?" Randi commented blandly.  
  
END PART 2/?  



End file.
